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Individual

GREGORY S KEELING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2817 NEW PINERY RD, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-9257
(608) 742-4131
(608) 745-5173
Mailing address
PO BOX 387, DIVINE SAVIOR HEALTHCARE INC, PORTAGE, WI 53901-0387
(608) 742-4131
(608) 745-5173

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
30905 020
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31651300
WI
Enumeration date
11/22/2005
Last updated
01/31/2012
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